Comparison of the risk prediction systems POSSUM and P-POSSUM with the Surgical Risk Scale: A prospective cohort study of 721 patients
| Autor: | Sergio González-Martínez, Isidro Martí-Saurí, José M. Pueyo-Zurdo, Montserrat Martín-Baranera, Nuria Borrell-Grau |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Emergency Medical Services medicine.medical_specialty 030230 surgery Risk Assessment 03 medical and health sciences 0302 clinical medicine Risk Factors Emergency medical services Health Status Indicators Humans Medicine Prospective Studies Prospective cohort study Aged business.industry Area under the curve General Medicine Middle Aged Surgical risk Surgery Elective Surgical Procedures Spain Area Under Curve 030220 oncology & carcinogenesis Female Observational study P possum Morbidity business Risk assessment Elective Surgical Procedure |
| Zdroj: | International Journal of Surgery. 29:19-24 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2016.03.005 |
| Popis: | The outcomes of surgery are subject to variability and difficult to be accurately predicted. Different score systems have been developed to estimating the risk of undergoing a surgical procedure. The aim of this study was to assess the predictive ability of POSSUM and P-POSSUM scoring systems, compared to the Surgical Risk Scale (SRS), in Spanish patients undergoing general surgery.In this prospective observational study, 721 consecutive patients needing a surgical procedure were included. Observed morbidity and mortality after surgery were compared to the expected ones obtained by applying POSSUM, P-POSSUM and SRS.Mean age was 59.2 years (standard deviation (SD): 17.4 years), 43.5% were women. 616 (85.5%) patients underwent elective general surgery and 105 (14.5%) emergency surgery. The 30-day morbidity was 15.4%. The reintervention rate was 2.1% and mortality was 2.1%. The discrimination ability was excellent in predicting mortality. The Area Under the Curve (AUC) values were: POSSUM: AUC = 0.97, C.I.95%: 0.948-0.992, p 0.0001; P-POSSUM: AUC = 0.966, C.I.95%: 0.941-0.991, p 0.0001; SRS: AUC = 0.91, C.I.95%:0.853-0.967, p 0.0001. POSSUM was also discriminative in the prediction of morbidity (AUC = 0.772, C.I.95%: 0.719-0.826, p 0.0001). POSSUM predicted morbidity and mortality were higher than the observed ones (p = 0.01 and p = 0.04). Predicted and observed mortality were very similar for P-POSSUM (p = 0.93) and SRS (p = 0.37).Expected morbidity and mortality determined by POSSUM score showed values significantly above the observed ones. P-POSSUM and SRS systems were effective in predicting mortality. The SRS application is simple and may contribute to appropriate medical decision making. |
| Databáze: | OpenAIRE |
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